Abstract 16171: Which Factor Affects Neointimal Condition After Drug-Eluting Stents Implantation More Strongly, Eluting Drug or Stent Design?: Optical Coherence Tomography Evaluation
Background: Some reports have revealed incomplete neointimal coverage after drug-eluting stents (DES) implantation as compared with bare metal stents (BMS), and delayed healing of neointimal coverage might be one of major factors for late stent thrombosis. On the other hand, recent available optical coherence tomography (OCT) is useful device to evaluate neointimal condition in detail. Eluting drug and stent design can affect neointimal condition after DES implantation, however, it is unknown which factor strongly affect the condition. Thus, in this study, we investigated effects of eluting drug and stent design on neointimal condition after DES implantation using OCT.
Method: Forty-eight patients who received DES (sirolimus-eluting stent (SES):27, paclitaxel-eluting Express2 stents (PES-E):8, paclitaxel-eluting Liberte stents (PES-L):13) were enrolled in this study. We investigated optical coherence tomography (OCT) parameters including neointimal hyperplasia area ratio (NHA ratio) defined as the ratio of neointimal hyperplasia cross-sectional area to stent cross-sectional area, covered strut ratio (Covered ratio) defined as the ratio of the number of covered struts to the number of observed struts, and malapposed strut ratio (Malappo ratio) defined as the ratio of the number of malapposed struts to the number of observed struts. At 8 momths after DES implantation, we compared these parameters between all PESs (PES-E and PES-L) and SES from the point of view of eluting drug, and between PES-E and PES-L from the point of view of stent design.
Result: NHA ratio and Covered ratio of SES were significantly lower than those of all PESs, while there were no differences between these parameters of PES-E and PES-L (figure).
Conclusions: Eluting drug itself strongly affects neointimal condition after DES implantation, while the effect of stent design on neointimal condition may be weak.
- © 2010 by American Heart Association, Inc.